This article contains posts and extracts from the UK Midwives and Consumers email list, a discussion group for people interested in midwifery in the UK. Open to midwives, students, mothers, and anyone interested in improving maternity services in UK. Posts in these archives express the views of the individual authors, and not those of the Association of Radical Midwives. Unless otherwise stated, the comments are personal experiences rather than evidence-based research.

Complementary and Alternative Therapies

Induction of Labour


See also: Sweeping the Membranes – a drug-free intervention which can help to induce labour.


A brief summary of traditional DIY methods:

Exercise lots! Bouncing up and down…

Sex, but especially oral sex – the ‘natural’ (and gentle) prostaglandins in semen are absorbed more effectively through the gut than through the cervix… if you can face it! (more on this below!)

Hot curry

Reflexology often very effective, if you can get organised and find someone to do it quickly.

Failsafe method of inducing baby: arrange lots of things to do in the next week that you would really enjoy – massage, facial, hairdresser, etc..!! Even if it doesn’t work, you’ll have a nice time…

Nipple stimulation – apparently you really need to keep at it for at least an hour, and that one way is to get going with a breast pump while you’re watching telly!


I have to agree with exertion as a possible means of induction. For the last three pregnancies I (not deliberately anytime) twice went for a long walk the previous day and ended up carrying a toddler for most of the way – ok so you haven’t a toddler – try a heavy rucksack :-)) This time I had a very stressful and energetic party for my oldest son’s 7th birthday the previous day !


‘Has anybody out there heard of asking mothers to eat lots of pineapples and bananas to ‘help soften the cervix’ (presumably near term)?’

I have heard that fresh pineapple contains a chemical similar to that in prostaglandin and so can have the same effect at term but it needs to be fresh, not tinned. Not heard of bananas though.

Donna


There is an extensive article on ‘natural induction methods‘ on the US Midwife Archives
(www.gentlebirth.org/archives/natinduc.html)


The other thing that can be done is to stop trying to induce the labour by whatever means, (If medical induction is not wanted, why are we trying to induce at all), and await events calmly. If there is no reduction in liquor volume, fetal movements are not changing, abdominal girth is not diminishing, there is no marked loss of weight and the woman feels good, what is the indication to try and start this labour? Hospital staff’s protocols/policies are not an indication. Liquor volume can be pretty accurately assessed by the woman feeling the tightness of her clothes on her abdomen; if they are getting looser liquor might be diminishing.

Why are we hassling women who are “overdue”? Vigilant inactivity seems to be another lost midwifery skill.

(a midwife)


HERBS AND HOMEOPATHY

< Remedies founders) Caulophyllum also goes by the common name of Blue Cohosh. So it might be worth asking for it by that name, but don't get it mixed up with black cohosh which is entirely different!>>

Caulophyllum is the homoepathic version of Blue Cohosh- Blue Cohosh is the herbal remedy. Basically that means that you can’t (as far as anyone knows) do any *harm* with homeopathic remedies, but there is little evidence from good quality trials that they are effective, either. There have been some studies suggesting good outcomes for homeopathy for certain ailments, but it seems really difficult to find studies with good methodology. I know that many people are certain that homeopathy has been effective for their families, but it is not something which I know much about I’m afraid.

However, I do use herbal medicine where necessary, and it’s a different ball game. Some herbal medicines can be just as harmful as anything you get on prescription, but the plus side is that there is a lot more evidence that they are effective. They need to be used with caution. If you’re desperate, there are quite a few things you can use – but then, if you don’t want pharmaceutical induction in hospital because of a VBAC scar, I’d worry about how advisable it was to induce labour using herbs, either.

Anyway… Blue Cohosh is the one most commonly recommended, but when a friend of mine was trying to get things moving we used Goldenseal. Her waters had broken and time was tapping on…. we read everythign we could get our hands on, went out shopping round health food shops, but the only thingwe could find near her was Goldenseal tincture, which is generally taken with Echinacea as an immune booster. Lots of health food shops sell it. So, she divided the dose into 2, took half before dinner, then had a curry and pint of lager. Nothing much happened – still the odd twinge every 20 minutes. Then she took the second half of the Goldenseal dose and within 15 minutes she was having contractions every 5 mins and had the baby about four hours later. Of course, we can’t guarantee that it was the Goldenseal that did it, but reading through books on herbalism and pregnancy I found several references to the herb having been used to induce labour in the past, but that it had fallen out of favour nowadays as it was ‘too strong’. This would really make me worry about using it when you wanted a VBAC.

Angela H.


Caulophyllum 200x – Also you could try Clary Sage 10 drops in a bath that works for some women.. and according to a friend of mine the best remedy is to wear your very best knickers the ones you really dont want ruined (water should break :o) ) I guess that is a variation of sods law..

L.


I found blue cohosh tinture to be helpfull in starting my labour and strenthening my contractions. According to The Childbearing Year by Susan Weed, take 3-8 drops in water every half hour until contractions begin. If labour is not underway in 4 hours then one dropperfull of the tincture on the tongue every hour should do it. Neals Yard stock blue cohosh. If they only have the root then try making a strong brew and sipping it throughout the day. Listen to your body. Nipple stimulation is also good plus sex. Susan Weed recomends having an orgasm and I have read that sperm on the cervix actually helps to start labour.


I didn’t try this but the homoeopathic remedy Caulophyllum 200x one every half hor for two hour is meant to work too. You’ll have to order it from a homoeopathic pharmacy.


You can get cohosh, blue and black, and golden seal and gelsemium (but be extremely careful with this and consult a herbalist first) from Neal’s Yard.

Lesley


Places to order herbal remedies:

I think that Neal’s Yard are not allowed to include instructions on the packaging for the same reason that they can’t have any claims for the product on the packaging – EU legislation about the sale of vitamins and non-pharmaceutical remedies. However, they do have a phone number you can ring for advice – 020 7627 1949 – and I’ve found them very helpful in the past.

Neal’s Yard also do mail-order:

Neals Yard Remedies sell every remedy under the sun and they do mail order (0161 831 7875). They have shops in London, Brighton, Bromley, Bristol, Norwich, Oxford and Totnes (Devon).

Neal’s Yard Their website (www.nealsyardremedies.com).

Helios (www.helios.co.uk) may be able to deliver next day. Tel. 24 hrs 01892 536393; or normal hrs 01892 537254) – they are very efficient. They can get it to you extra fast for not much extra if you use a credit card.


Oral Application of Semen, From the US midwife archives

About fellatio: Actually, it would probably be beneficial, if the idea is to get the labour started. A great OB in Hamilton (John Lamont, I believe) spoke to our class about sexuality and pregnancy. He mentioned the concept that prostaglandins are absorbed 10X more efficiently through the gut than through the vaginal mucosa, with respect to semen and labour onset.


Castor Oil

I remember reading somewhere that castor oil can cause particularly strong contractions and has been associated with foetal distress, as well as the maternal distress caused by the discomfort of course! On the other hand, plenty of women take the stuff and have no results whatsoever from it. I suppose the problem is that you just don’t know what effect it’s going to have on your body until you try it.

Angela


A bit like prostin gel really!!

Andrea


The active ingredient of castor oil is ricinic acid. The pharmocological name is oleo ricini. It is a powerful laxative and acts by stimulating the gut. If labour is not far off castor oil will stimulate the uterus to contract – Castor oil contractions – this will give the uterus enough of a “kick Start” to start off labour. As it is often used when a pregnancy is post term there is often meconium in the liquor This is not sinister. It is a feature of the postmature fetus Its gut has matured amd it has passed meconium. This is not in itself a sign of fetal distress.

Before the days of of synthetis oxytocic drugs we used “ol ric” frequently to start, and augment labours. I still suggest it to women occasionally.

The dose is 25-30 mls It is disgusting to take. I mix it with a similar amount of a sour fruit juice, lemon or grapefruit, shake it up, give it to the victim to swig, then pass her a tissue to wipe her mouth, then give her a dry biscuit to eat. I took it myself on two occasions – YUK YUK YUK

Mary Cronk, independent midwife
www.marycronkmidwiferyservices.co.uk


I think that I would have been prepared to try castor oil to induce labour, despite the side effects, if it meant that I could stay in control and not get transferred up the system. (i.e. from GP unit to consultant unit) When I went overdue with my third the GP unit wrote me off and referred me back to my GP who was unable to get consultant unit cover immediately.

I’d rather stay in control and drink a glass of disgusting liquid at home than have ARM done by a consultant with no consent in hospital! Point taken about the lack of research, but seriously, can you think of any centre that would bother to do and RCT (randomised, controlled trials) when there are so many other methods of IOL (induction of labour)?

Margaret


We gave 4 fl oz caster oil + orange juice + 1/2 tsp. bicarbonate of soda, which caused it to fizz and made it a little more pleasant to take!

The assumption was that it is a rectal stimulant and because the nerve supply to the rectum passed through the same plexuses as the uterus, it would stimulate labour. Having given it to women for a few years in the late 60s and early 70s, I believe it was effective for those at term. Many went into labour within 12 hours of taking it.

I agree that it is not particularly pleasant, but is better for many women than invasive procedures to induce labour. However, I also agree that research should be undertaken before recommending it.

Ruth


My mum has horrific memories of Castor oil to try and induce labour when she was pregnant with me. At 41 weeks her blood pressure went up and she was admitted to hospital for induction. She has no doubt that it may have helped to stimulate her labour but would not wish the other unpleasant side effects on anyone. She also says it took at least two doses so maybe labour started spontaneously anyway and everyone just put it down to the castor oil. (This was in 1966)


4 oz castor oil in orange juice mixed well and swallowed fast (it tastes foul) causes a bad case of the runs but I have found it helps to start labour. another dose can be given 12 hrs later. if it does not work, perhaps this baby is simply not ready.


Castor oil was used by generations of women earlier this century before the advent of evidence based practise. It was foul, it did indeed give a dose of the runs and women found this totally unpleasant. And I seriously question that it did ever induce labour. It has never been the subject of a research study as far as I know and in my opinion should not be recommended to anyone unless it is.

Linda


“I came across a worrying article stating that any type of ‘natural’ induction is very dangerous and that use of castor oil could lead to cord prolapse.”

I have been using castor oil to encourage labour in women who wish for various reasons to do this for over thirty years with discrimination and I would be interested to know why the wide statement is made that it is not advisable.

Of course, like anything else there are contraindications and I carefully question the woman as to:

  1. Why she wants to encourage her baby to be born before the spontaneous onset of labour.
  2. Has she any history of irritable bowel syndrome or any other gut problems
  3. Has she any piles or any history of piles.

I then offer to examine her vaginally to assess the cervix as in my experience if the Cx. is not ripe the castor oil is unlikely to start labour. I also check the presentation and station of the head and would advise not to proceed if the presentation was other than cephalic and well in the pelvis. There is a danger of cord prolapse if any labour starts with a malpresentation and a high presenting part and therefore if castor oil is taken and there is a prolapse of cord, the castor oil is blamed .

If all is well, I suggest she take 25-30 mls of castor oil mixed with the same amount of a sour sharp fruit juice like lemon or lime or grapefriut, have an assistant beat the nauseous mixture, hand it to the woman, who drinks it as quickly as she can, the assistant then removes the glass and washes it carefully so that no smell or taste lingers, the woman wipes her mouth with a tissue she has ready, eats a crisp dry biscuit or dry toast and awaits events.

Mary Cronk, independent midwife
www.marycronkmidwiferyservices.co.uk


USE OF CASTOR OIL IN PREGNANCIES AT TERM

David Garry, DO, Reinaldo Figueroa, MD, Jacques Guillaume, MD, and Valerie Cucco, DO

Context . Despite wide use of castor oil to initiate labor, the obstetric literature contains few references to this botanical laxative. Derived from the castor plant Ricinus communis, castor oil may possess properties that are useful in post-term pregnancies.

Objective . To evaluate the relationship between the use of castor oil and the onset of labor.

Design . Prospective evaluation.

Setting . A community hospital in Brooklyn, NY.

Patients . A total of 103 singleton pregnancies with intact membranes at 40 to 42 weeks referred for antepartum testing. Inclusion criteria included cervical examination, Bishop score of 4 or less, and no evidence of regular uterine contractions.

Intervention . Patients were alternately assigned to 1 of 2 study groups: a single oral dose of castor oil (60 mL) or no treatment.

Main Outcome Measures . Castor oil was considered successful if labor began within 24 hours after dosing. Groups were compared for onset of labor in 24 hours, method of delivery, presence of meconium-stained amniotic fluid, Apgar score, and birth weight.

Results . Fifty-two women received castor oil and 48 were assigned no treatment. Following administration of castor oil, 30 of 52 women (57.7%) began active labor compared to 2 of 48 (4.2%) receiving no treatment. When castor oil was successful, 83.3% (25/30) of the women delivered vaginally.

Conclusions . Women who receive castor oil have an increased likelihood of initiation of labor within 24 hours compared to women who receive no treatment. Castor oil use in pregnancy is underreported worldwide. This small series represents the first attempt to evaluate the medication.

(Altern Ther Health Med. 2000;6(1):77-79)


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Aromatherapy

For Christmas my friend has bought me some aromatherapy bath stuff. The thing is I’m sure I’ve read somewhere that some oils are a bad plan in pregnancy, has anyone else heard of this and if so, which oils are they??

It is often said that essential oils should be used with caution during pregnancy – sensible, as all foods and medicines should be used with caution then I suppose. However, I do wonder if the worries over essential oils are perhaps disproportionate to the risks. I have not yet heard of a single case where a pregnancy problem was attributed to essential oil use. Medline appears to list *no* research studies which explicitly investigate dangers of essential oils in pregnancy – the most relevant is simply one which considers the ‘possible dangers’ of using them incautiously. It is quite a different thing to say ‘This item MAY be dangerous if you’re not careful’, as opposed to ‘We have evidence that this item is dangerous’.

As far as I’ve been able to gather, most of the concerns about essential oils seem to concern those oils that are said to act as uterine stimulants or to help in labour by strengthening contractions (eg Clary Sage). It is suggested that they might – just might- make you more prone to miscarriage if used in early pregnancy, or perhaps to premature labour if used in late pregnancy. I wonder if this is really likely, since many things strengthen uterine contractions but are not contraindicated in normal pregnancy, eg sex and nipple stimulation. If you were at risk of miscarriage or premature labour then you might want to be extra-careful.

The other category of oils that are often mentioned (and which overlaps with the above category), are emmenagogues – those said to bring on or hasten a period. These include Rose and Chamomile. These sorts are sometimes only said to be best avoided in the first trimester, in case they might affect the miscarriage risk. I’ve never seen any evidence that these oils can actually work to hasten a period, which presumably would have to happen by shortening the luteal phase after ovulation, ie somehow overriding the corpus luteum, which sounds like a pretty major job. Nonetheless, you might not want to chance it.

Since none of us wants to take silly risks, it is probably sensible to avoid *certain* essential oils at some or all stages of pregnancy, and to use others with caution. I’ll list below those oils which a selection of sources recommend not to use in pregnancy. However, there are many essential oils that are widely used and considered perfectly safe – and very *nice* to use – in pregnancy, so there is no need to avoid *all* essential oils -just make sure you know what you’re using.

WHAT ARE ESSENTIAL OILS?
Essential oils (also called volatile oils) contain plant chemicals which can be absorbed through the skin, when it is used for massage, through the digestive tract, when (occasionally) they are taken internally, or through the respiratory tract when you smell or breathe them in.

In some cases just the smell itself is said to have a particular psychological effect, eg of relaxing you, whereas in others the chemicals act in other ways apart from smell. For example, if you’ve ever used something like Eucalyptus oil or Olbas oil or Karvol capsules, or similar, to help unblock your nose, you’ve used aromatherapy and taken advantage of the effect these chemicals have on some of your mucous membranes. It’s not just a case of ‘smell to get well’; essential oils may smell nice, but they can affect you in other ways too.

Another example of this is Cedar and Pine essential oils; I have looked into their effects on rodents (as pets are often kept on wood shavings) and essential oils from these woods can cause a change in liver enzyme levels which affects their metabolism of fats and can be harmful or beneficial depending on the individual case. The effect is so strong that laboratories are advised not to keep rodents on wood shavings if they are conducting experiments which may involve liver function tests or measurements of enzyme levels. This shouldn’t worry humans unduly, by the way – bear in mind that rodents kept on these shavings as litter are surrounded by essential oils being given off in huge quantities all the time. It’s as if you lived in one room and it was knee-deep in cedar or pine shavings. You do not need to worry about the odd pine cone or cedar moth repellent stick having the same effect on you.

DIFFERENT PRODUCTS, DIFFERENT RISKS
Right, back to humans. The next thing is to look at the sort of product you have. Many aromatherapy’ products contain very small amounts of essential oils, used really just to perfume the product. The broad categories are: pure essential oils, diluted ‘aromatherapy’ oils, and ‘aromatherapy products’.

PURE ESSENTIAL OILS
Pure essential oils are very concentrated and powerful. Herbalists and specialist aromatherapy suppliers sell pure essential oils – eg Culpepers, Neal’s Yard Remedies, etc. . Such suppliers will always have warnings at the point of sale and on the bottle stating that pure essential oils must be used with caution. When aromatherapy books etc.. advise that you avoid certain essential oils, you should certainly steer clear of using the concentrated pure oils in the categories they suggest, unless you know a lot about the subject.

DILUTED AROMATHERAPY OILS 
In contrast, most less specialist shops selling ‘essential oils’ or ‘aromatherapy oils’ will not be selling pure or highly concentrated oils. All oils sold in the Body Shop, for example, are diluted – often so that the pure essential oil is less than 10% of the final product. If in doubt, check the label. These are far cheaper than pure essential oils. If you wanted to buy 15ml of pure rose essential oil, for example, it might cost you £70 or more – yet the Body Shop will sell you a tiny bottle of dilute rose oil for under a fiver. The oils are normally diluted with ‘carrier oils’ like grapeseed oil, wheatgerm oil, etc.. Personally I would also steer clear of diluted essential oils of the types contraindicated for pregnancy.

Considering the above two categories, if for example you go for a massage, make sure you tell the masseuse that you are pregnant so that she can select safe oils. If you use essential oils yourself, read on (or read up elsewhere!) for lists of safe ones. Common sense suggests to me that taking an oil internally (not often done anyway) or having it massaged onto your skin, or use it in a steam inhalation, is going to cause you to take in a lot more of the active ingredients than if you just put 2 or 3 drops in an oil burner to scent your room.

OK, here’s the third category:

AROMATHERAPY ‘PRODUCTS’
Most ‘Aromatherapy products’ contain much less essential oil than even diluted oils. They might include things like bubble bath, room spray, shampoo, soap, etc.. The essential oil here is used mainly to perfume the product. Bear in mind that all perfumed products contain some added ingredients to give the smell – some of those will be essential oils, some will be extracted compounds of essential oils, others may be synthetic copies. However, unless you stick to using only unperfumed toiletries, I doubt that you will be able to avoid essential oils altogether.

I had a discussion about this with a sales advisor at Lush last week. This is a company which sells products perfumed with essential oils and herbal extracts. If you’ve ever smelt their products, it’s pretty clear that they use significantly more essential oils than many other ‘aromatherapy products’! They are also known as a highly ethical company, so I was interested to hear their official line. I was told that they frequently get queries about safety in pregnancy and they reassure people that because all the essential oils used are so dilute, there is no need to avoid any product. What you need to be careful about are essential oils themselves.

This seemed a pretty sensible line to me. If you’re in any doubt about how suitable a particular product is, you could call the manufacturers – is there a helpline number on the packaging? Generally, though, it seems sensible to take care with essential oils themselves, but not to worry too much about toiletries that contain a minute amount just as perfume.

WHICH OILS TO AVOID IN PREGNANCY? 
OK, now which oils are considered unsafe for pregnancy? Some sources are annoyingly unspecific about this – what I’d like to know is *why* a particular substance is considered unsafe, and so on. Usually if you dig deeper, it turns out to be because the oil is thought to be a uterine stimulant, and people worry that use may bring on miscarriage or premature labour. So here’s the best I can find:

Bartram’s Encyclopaedia of Herbal Medicine , by Thomas Bartran, Fellow of National Institute of Medical Herbalists. A well-respected reference work on herbalism, also interesting in that it ties together developments in ‘conventional’ and ‘complementary’ medicine.

Says the following oils are not used in pregnancy: Bay, Bachu, Chamomile, Clary Sage, Cinnamon, Clove, Fennel, Hyssop, Juniper, Marjoram, Myrhh, Peppermint, Rose, Rosemary, Sage, Thyme

Says the following should not be used *at all*, not just during pregnancy (ie of the 2,000 plants that yield essential oils, these ones should not be used therapeutically – apparently only 50 or so are generally used): Basil, bitter almonds, boldo, calamus, horseradish, mugwort, mustard, pennyroyal, rue, sassafras, savin, tansy, thuja, wormseed.

‘Aromatherapy’ by Micheline Arcier. The author is described as someone who practised aromatherapy for 30 years and is ‘considered a leading authority in the field’. In her book she does not specifically list oils to avoid -she says:” Many essential oils are not suitable in pregnancy, becaue a baby could absorb too much from its mother. Any essential oil that stimulates menstruation is not suitable, particularly at the beginning of pregnancy”. Instead, she lists oils which *are* suitable in pregnancy (see below for her list).

‘Natural Healing for Women’ by Susan Curtis and Romy Fraser, founders of Neals Yard Remedies. This is a very helpful book on natural remedies in general. They say the following oils should be avoided in pregnancy: Aniseed, Basil, Camphor, Caraway, Cedar, Cinnamon, Clary Sage, Cypress, Fennel, Hyssop, Juniper, Marjoram, Myrhh, Nutmeg, Oreganum, Peppermint, Pennyroyal, Rose, Rosemary, Sage, Savoury, Thuja, Thyme, Wintergreen.

Now, this is one of those annoying lists as it doesn’t go into more detail. Particularly as Rose and Clary Sage are often recommended for use during labour, and the same book recommends rose oil as good for massage towards the end of pregnancy.

‘Aromatherapy’ by Cathy Hopkins is a useful little book. This one recommends avoiding the following ‘especially during the first three months’: clary sage, fennel, peppermint, rosemary, cypress, cinnamon, basil, pennyroyal, hyssop, myrhh, savory, sage, thyme, oreganum, jasmine, juniper, marjoram and rose.

I think she is referring to using oils for massage as she then goes on to say that baths with a few drops of lavender and chamomile are great for pregnancy.

OILS WHICH *ARE* RECOMMENDED FOR PREGNANCY 
From various sources -Tangerine, Neroli, mandarin, lavender

From Micheline Arcier’s book ‘Aromatherapy’: Chamomile, Geranium, Incense, Lavender, Lemon, Neroli, Orange, Sandalwood, Tangerine, for various purposes, and the following for colds etc: cajuput, eucalyptus, niaouli, pine.

WHAT’S THE EVIDENCE FOR ALL THIS?
I get the impression that much of the advice to avoid certain oils is speculative. Medline certainly doesn’t have many published papers on the subject. I found only three making any reference to it on a search under ‘aromatherapy’ and ‘pregnancy’, of which one said that some essential oils were more effective in combination than singly, and that perhaps people should be careful about using combinations in pregnancy (but still no specifics). Another had no abstract or details. A third looked interesting, but unfortunately the abstract tells us very little apart from mentioning the nebulous ‘dangers’ of using oils without knowing more about them – here’s the abstract:

Aromatherapy in midwifery: benefits and risks. 
AUTHORS: Tiran D AUTHOR AFFILIATION: University of Greenwich, Elizabeth Raybould Centre, Kent, UK.
SOURCE: Complement Ther Nurs Midwifery 1996 Aug;2(4):88-92

ABSTRACT: This paper examines the potential dangers for pregnant, labouring, and newly delivered women of using essential oils without adequate knowledge of the actions of the chemical constituents of the oils. Although the discussion focuses specifically on the use of essential oils by midwives, the principles could equally apply to other health professionals.

TO SUM UP-I would be interested in finding out whether there are any documented cases of essential oils causing problems with pregnancy; as mentioned before, I’ve not found any yet, but if you know of some – please let me know. I do worry that all this is a little overblown given that there are so many other factors where there is strong evidence that the miscarriage risk is increased – eg taking folic acid supplements appears to increase the miscarriage rate; it seems a bit premature to be discouraging women from using something which could help them to relax etc,, without evidence that it does any harm.

It seems to me that there is a great difference between using pure essential oils directly onto the skin, and a smidgen of oil in a bubble bath mixture. There is a lot of difference between the first and third trimesters, and a lot of difference between a woman who has threatened miscarriage or preterm labour, and one who hasn’t. Thoughts, anyone?

One thing to be careful of if using essential oils is that, as with virtually anything else, you might be allergic to certain oils. Watch out for allergic reactions or skin conditions after you’ve used any product, and remember that sensitisation may occur after you’ve been using things for a while. I come up in lovely rashes from minute splashes of various substances including various household cleaning products, no matter how dilute, and also cinnamon essential oil.

Angela Horn (Not a midwife, or an aromatherapist – but an interested mother) Home Birth Reference Site (www.homebirth.org.uk)


A company called Aromatherapy Associates (www.aromatherapyassociates.com) had a stand at the recent Prima Baby Show at Olympia. I know they have a special range of products for pregnant mums and they may be able to give further advice on this.

info@aromatherapyassociates.com

Kathy


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Morning Sickness / Nausea

From www.mothernature.com/ency/Homeo/Morning_Sickness_hm.asp

Asarum: This remedy is indicated when a woman feels very ill, with constant nausea and retching. She is extremely sensitive to everything-especially noise, which can aggravate the nauseous feelings. She feels best when lying down and resting. Cool drinks or food may help, but it is hard for her to even think of eating.

Colchicum: Horrible nausea that is worse from the sight and smell of food (especially eggs or fish) often indicates this remedy. The woman retches and vomits, and has a sore and bloated feeling in the abdomen. She has trouble eating anything – although she often craves things, when she tries to eat them they make her sick. She is likely to feel ill from many smells that others don’t even notice.

Ipecacuanha: This remedy is indicated for intense and constant nausea that is felt all day (not only in the morning) with retching, belching, and excessive salivation. The woman may feel worse from lying down, but also worse from motion. Even after the woman vomits, she remains nauseous.

Kreosotum: When this remedy is indicated, the woman may salivate so much that she constantly swallows it, becoming nauseous. She may also vomit up food that looks undigested, several hours after eating.

Lacticum acidum: This remedy is indicated for “classic morning sickness”: nausea worse immediately on waking in the morning and on opening the eyes. The woman may salivate a lot and have burning stomach pain. She usually has a decent appetite and feels better after eating.

Nux vomica: Nausea, especially in the morning and after eating, may respond to this remedy-especially if the woman is irritable, impatient, and chilly. She may retch a lot and have the urge to vomit, often without success. Her stomach feels sensitive and crampy, and she may be constipated.

Pulsatilla: This remedy can be helpful if nausea is worse in the afternoon and evening (often in the morning, as well). The woman is not very thirsty, although she may feel better from drinking something cool. She can crave many different foods, but feels sick from many things (including foods she craves). Creamy foods or desserts may be appealing, but can cause discomfort and burping or bring on vomiting. A woman who needs this remedy usually is affectionate, insecure, and weepy-wanting a lot of attention and comforting.

Sepia: Gnawing, intermittent nausea with an empty feeling in the stomach suggests a need for this remedy. It is especially indicated for a woman who is feeling irritable, sad, worn out, and indifferent to her family. She feels worst in the morning before she eats, but is not improved by eating and may vomit afterward. Nausea can be worse when she is lying on her side. Odors of any kind may aggravate the symptoms. Food often tastes too salty. She may lose her taste for many foods, but may still crave vinegar and sour things.

Tabacum: This remedy can be helpful to a woman who feels a ghastly nausea with a sinking feeling in the pit of her stomach. She looks extremely pale, feels very cold and faint, and needs to lie very still and keep her eyes closed. If she moves at all, she may vomit violently-or break out in cold sweat and feel terrible.

From www.arrowroot.com/artphho.htm

Morning Sickness

1. Heavy and full, not thirsty – Pulsatilla Nig.

2. Persistant nausea, not relieved by vomiting – Ipecacuanha

3. Feels empty, better for eating – Sepia

4. Excessive retching and straining – Nux Vomica

5. Feels empty, can’t keep cold drinks down, nausea on putting hands in warm water – Phosphorus Ruber.

Herbal Approaches

Cloves, Comfrey, Ginger, Ginseng, Milk Thistle (Silymarin), Red raspberry plant.

Ginger is probably the best-known carminative (removing gas and relaxing the intestinal tract).

Milk Thistle supports the liver, which may be having difficulty detoxifying. However, a number of studies implicate psychological problems, like the relationships and the desirability of being pregnant.

Aromatherapy – Essential Oils

Jasmine Essence, Neroli Essence, Rose Essence, Sandalwood Essence.

Morning Sickness: Cardamom Essence, Coriander Essence, Ginger Essence, Peppermint Essence.

 

Another herbal remedy for morning sickness I found in my own stuff is meadowsweet (filipendula)

Max


I found ginger invaluable for relief of nausea in both my pregnancies -would simply munch a piece of crystallised ginger when I felt nauseous.

I have not found any advice against ginger in any of my herbal reference books. The main one I use is Bartram’s Encyclopedia of Herbal Medicine (Robinson, 1995), by Thomas Bartram, Fellow of the National Institute of Medical Herbalists. This is a well-respected text, and is fairly comprehensive. In general (not specific to ginger) it discusses many cases where conventional medicines are recommended over/alongside herbal ones, and includes references to research papers, and I think this is one of the reasons why it is well-respected. Anyway, Bartram recommends ginger for morning sickness and does not state any contraindications in pregnancy. The only contraindication he mentions is kidney disease.

Angela


Ginger treatment of hyperemesis gravidarum

Fischer-Rasmussen W, Kjaer SK, Dahl C, and others

European Journal of Obstetrics and Gynecology and Reproductive Biology , vol 38, no 1, 1990, pp 19-24

Thirty women participated in a double-blind randomized cross-over trial of the efficacy of a natural product, the powdered root of ginger (Zingiber officinale), and placebo in hyperemesis gravidarum. Three patients had to be withdrawn. Each woman swallowed capsules containing either 250 mg ginger or lactose q.i.d. during the first 4 days of the treatment period. Interrupted by a 2 days wash-out period the alternative medication was given in the second 4-day period. The severity and relief of symptoms before and after each period were evaluated by two scoring systems. The scores were used for statistical analyses of possible differences.

Subjectively assessed, 19 women (70.4%) stated preference to the period in which ginger, as was later disclosed, had been given (P = 0.003). More objectively assessed by relief scores a significantly greater relief of the symptoms was found after ginger treatment compared to placebo (P = 0.035).

No side effects were observed. The possible mutagenic and antimutagenic characters of ginger reported in a study of E. coli have not been evaluated with respect to any significance in humans. Powdered root of ginger in daily doses of 1 g during 4 days was better than placebo in diminishing or eliminating the symptoms of hyperemesis gravidarum. (10 references) (Author)


For more information on Hyperemesis Gravidarum, see Blooming Awful (www.hyperemesis.org.uk)


Babies’ sore skin

Many moons ago (around 1975) while working on an infectious diseases (barrier nursing) baby ward, we used to clean sore and raw little bottoms with cotton wool and olive oil (high grade). These were babies with gastro-enteritis so you can imagine how very raw their wee botts were. It seemed to soothe very effectively – we never put water near the sore skin. It was the practice of the day.

Brenda, Midwife


Heartburn

  • Separating proteins and starches in the diet
  • Increasing folic acid intake
  • Decrease intake of yeast-containing foods
  • Slippery elm… Simmer 1/2 tsp of slippery elm powder in 1 C Boiling water for 20 mins. Or mix 1 tsp with some honey and eat. Or take capsules.
  • Chewing raw almonds
  • Slowly Sipping milk
  • Eating yogurt
  • Don’t drink with meals
  • Anise, fennel, peppermint or spearmint teas

For me, my cure was eating raw potato!

Andrea


I have found peppermint tea (cooled or warm) very effective for heartburn, whether pregnant or not. No coincidence that many heartburn remedies from the pharmacist are flavoured with peppermint. It is supposed to have an effect on the sphincter muscle at the top of the stomach. Peppermint tea bags are available from all health food stores and some supermarkets.

Angela


Homeopathic remedies would be Bryonia, Causticum, Nux Vomica, Nat Mur, Pulsatilla, Merc, Zinc. You could ring Helios in Tunbridge Wells, who do a mail order service, and give excellent advice. Ring between 10 and 5 . A Bottle of whatever they suggest will cost around £5.oo including P&P. Tel: 01892 537354.

Debra


Haemmorhoids

I have found lemon juice to be absolutely marvelous. Every time you use the bathroom, wipe your bottom with a piece of fresh lemon. You will find the hemorrhoids will heal from the outside in. When you first apply the lemon the area will itch because the lemon is shrinking the hemorrhoids. I also suggest doing pelvic rocks before bed and resting during the day with your feet up to relieve the pressure on your body.

Robe


Many good herbal and homeopathic remedies that can be used prenatally are available to strengthen your vessels. For labor and birth, lying on the side opposite your hemorrhoids is an excellent position. Also have your midwife keep some 4x4s or washcloths soaking in a bowl of ice water (with a squirt of antibacterial). This can be used to provide you with counter-pressure during pushing. Most women find the cool pressure nice against the “ring of fire” and the cold/pressure reduces and prevents the hemorrhoids from coming out, along with the reduced pressure of being on your side. Borion makes a great combination homeopathic for hemorrhoids that can be used postpartum, if necessary, and the standby trick of soaking pads with witch hazel, putting them in the freezer, and applying them as needed also works great.

Christina, midwife


Hypnosis for pain relief in labour

A good start is a little book by Elaine Sheehan entitled “Self-hypnosis” – I got mine in the public library. It is a very good (although VERY simple) introduction to hypnosis and actually teaches you self-hypnosis techniques “for everyday problems”. It also gives you names and addresses (but no phone numbers) of recognised organisations such as the British Society of Medical and Dental Hypnosis, or the Hypnotherapy Register held by The National Council of Psychotherapists – you’ll find them on the web or the phone directory.

  • National College of Hypnosis and Psychotherapy – 01282 699378, hypnosis_NCHP@compuserve.com (their prospectus looks home-made, but the content is much better than in any other brochures)
  • London College of Clinical Hypnosis – 020 7402 9037, www.lcch.co.uk
  • Institute of Clinical Hypnosis – Tel. 020 8675 1598

Anna (student midwife)


I use both post hypnotic suggestion and helping the woman to access self hypnosis. The abreactions I have had have been in the early stages of treatmen, when first inducing the hypnotic state which is a necessary prelude to both post hypnotic suggestion and self hypnosis.

Mary Cronk, independent midwife
www.marycronkmidwiferyservices.co.uk


HypnoBirthing – London hypnotherapist Deborah Henley teaches HypnoBirthing – “a method of natural childbirth enhanced by hypnosis, allowing women to call upon their natural instincts to bring about safer, more comfortable childbirth.”.
(www.hypno-birthing.org.uk)


See also: Sweeping the Membranes – a drug-free intervention which can help to induce labour.

Many thanks to Max, specialist archivist for complementary therapies on the UK Midwives and Consumers mailing list, for collating these posts – and to Sun, specialist on post-term pregnancy, for additional material on castor oil.

AH updated 30 September 2001

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